How To Order
919-403-0255

For individual orders, please complete and return the information below. Distributors and retailers, please contact ShieldWorks directly by phone, fax or e-mail. Download the form as text here Or use the print function on your Browser to print the following form below.

Name_____________________________________________________ Address__________________________________________________ City____________________________State________Zip_________ Tel:(req. for shipping)__________________________________ Fax:_________________________E-mail:_____________________ Please send me: ________CyberCap(s) @ $39.95 + $4.95 S/H per unit __Copper __Silver ________CyberCap(s) w/ drape @ $49.95 + $4.95 S/H per unit __Copper __Silver ________Scarf(Cotton) @ $39.95 + $4.95 S/H per unit __Black __Deep Blue ________Scarf(Silver) @ $39.95 + $4.95 S/H per unit __Black __Deep Blue ________Vest(s) @ 85.00 + $4.95 S/H per unit __Black __Deep Blue __S(34-38)__M(40-44)__L(46+) ________Apron(s) @ $110.00 + $4.95 S/H per unit __Black __Deep Blue ________Sheet(s) @ $199.95 + $4.95 S/H per unit __Biege __Deep Blue ________T-shirt(s) @ $19.95 + $4.95 S/H per unit ________Sweatshirt(s) @ $29.95 + $4.95 S/H per unit (NC residents please add 6% sales tax to your order total. Overseas orders shipped at cost ) V/C, M/C, Check (please allow 10 business days for check processing) VISA/MC #__________________________Expiration date____________ Signature____________________________________________________ Mail or fax to: ShieldWorks, 5821 Mt. Sinai Rd., Durham, NC 27705 Tel: 1-919-403-0255 Fax: 919-644-7068 Email: cybercap@mindspring.com (Please allow 4 weeks for delivery) ShieldWorks, CyberCap, and Sunglasses For Your Brain are trademarks of ShieldWorks, Inc. 1995. Patent Pending. 1996, ShieldWorks, Inc.

<cybercap@mindspring.com> LAST UPDATED:June 3, 1997 A KitchenMedia WebSite

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